Provider Demographics
NPI:1568854479
Name:THE CENTERED LIFE PROJECT
Entity Type:Organization
Organization Name:THE CENTERED LIFE PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-659-3763
Mailing Address - Street 1:133 IVY LN
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4417
Mailing Address - Country:US
Mailing Address - Phone:610-659-3763
Mailing Address - Fax:610-878-9331
Practice Address - Street 1:133 IVY LN
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4417
Practice Address - Country:US
Practice Address - Phone:610-659-3763
Practice Address - Fax:610-878-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015415251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health